Misty D Poole (NPI# 1134358419, PAC ID# 7810144177) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1134358419 |
| PAC ID by PECOS | 7810144177 |
| Professional Enrollment ID | I20120822000427 |
| Full Name | Misty D Poole |
| Organization Legal Name | MISTY D. POOLE, MD LLC |
| Address |
210 Mose Coleman Dr Vidalia GA 30474-8677 |
| Phone Number | 9125372200 |
| Gender | F |
| Medical School | MERCER UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2009 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 4183871437 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110128 | MEADOWS REGIONAL MEDICAL CENTER |
| 110024 | CANDLER HOSPITAL |
| 111333 | JEFF DAVIS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 210 Mose Coleman Dr, Vidalia, GA 30474-8677 | 9125372200 | MISTY D. POOLE, MD LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_128_overall | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 100% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% |
| Organization Legal Name | MISTY D. POOLE, MD LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Lauren Dasher | Physician Assistant | Misty D. Poole, Md LLC | 210 Mose Coleman Dr, Vidalia, GA 30474-8677 |
| Street Address |
210 MOSE COLEMAN DR |
| City | VIDALIA |
| State | GA |
| Zip | 30474-8677 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Lauren Dasher | Physician Assistant | Misty D. Poole, Md LLC | 210 Mose Coleman Dr, Vidalia, GA 30474-8677 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Casey Spivey | Orthopedic Surgery | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Karen Pamela Mcneely | Nurse Practitioner | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| David H Paine | Internal Medicine | 1006 A Mt Vernon Rd, Vidalia, GA 30474 | |
| Walter J Revell Jr. | General Surgery | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| Archie J Champion | Physician Assistant | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Letty Revell Peterson | Dermatology | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| Charles M Spivey | Orthopedic Surgery | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Richard M Proenza | Physician Assistant | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Paul J Giles | Cardiovascular Disease (cardiology) | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Robert Andrew Bell | Nurse Practitioner | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Find all physicians in zip 30474 | |||
| City | VIDALIA |
| Zip Code | 30474 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | VIDALIA + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Misty D Poole.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.